What is telePsychiatry?
TelePsychiatry leverages telemedicine in psychiatry to provide behavioral health coverage for hospital emergency departments as well as consultation-liaison psychiatry inpatient consultations anywhere in the hospital.
Comprehensive Behavioral Health Care Through Telemedicine
TelePsychiatry is the diagnosis and treatment of mental health patients by a remote clinician, such as a tele psychiatrist, using telecommunications technology like videoconferencing. It makes it possible for a psychiatrist and patient to be in separate rooms, cities, states, or even countries and still be connected face-to-face.
When a patient with mental health or substance abuse issues arrives at the ED, they are triaged similar to any other illness. Once any medical issues are established or eliminated, the patient is typically isolated and monitored closely. Hospitals request a behavioral health consult, and the patient is seen by the remote tele psychiatrist. Treatment options are discussed with the patient, the patient’s family, and onsite staff.
How does telePsychiatry work in a hospital?
The use cases for telePsychiatry are well-established in hospitals.
In the emergency room, remote specialists—often a tele psychiatrist— can “beam in” to consult with the patient and onsite staff for patients with mental health or substance abuse issues. Tele psych services can also be used with admitted patients when mental status changes occur due to anxiety or stress. By integrating telemedicine in psychiatry across the care continuum, hospitals can ensure timely, high-quality mental health support for patients in any unit.
Behavioral Health Care Across the Care Continuum with TelePsychiatry
Using Telemedicine to Overcome Behavioral Health Hospital Challenges
Access TeleCare helps behavioral health hospitals care for more patients locally, reducing transfers and improving care with timely access to behavioral health specialists.
Accelerate Emergency Throughput With Telemedicine
With Access TeleCare, hospitals have the ability to more quickly move patients through their emergency departments to the advantage of patients and emergency department care teams.
How do mental health and substance abuse patients impact the Emergency Department?
Medical emergency departments are not designed to handle large volumes of mentally ill patients. ED physicians are understandably uncomfortable determining the plan of care in a silo as the vast majority have not received in-depth behavioral health training. There are several ways an Emergency Department can be impacted:
Who We Serve
What is boarding?
Boarding is the term used to describe the wait time a mental health patient experiences after diagnosis but before inpatient treatment. On average, mental health patients can wait 8 to 34 hours for an inpatient bed. Just about every hospital or ED physician can tell you stories about much longer waits—100s of hours, even days. According to a recent poll, 70% of emergency physicians reported psychiatry patients being boarded in the ED on their last shift.
An inpatient bed is not a certainty, however. Inpatient psychiatric services have declined sharply, making post-discharge placement a very real challenge.
- There has been a 77.4% reduction in inpatient psychiatric capacity nationwide
- And $5 billion in additional state funding cuts between 2009-2012
How can emergency departments decrease suicides with telePsychiatry?
Suicide is currently the 10th leading cause of death in the U.S. and suicide rates have risen sharply over the years―increasing by more than 30% in most states. Because so many mental health patients present to the ED, we have a unique chance to screen these patients for suicide risk.
The Joint Commission reviewed its National Patient Safety Goal for suicide prevention, adjusting the requirements (NPSG 15.1.1) as of July 1, 2019. All hospitals participating in the Hospital Accreditation Program are now required to screen patients for suicidal ideation and conduct a risk assessment. Those patients identified and documented as moderate- or high-risk require a plan—mitigating the risk of suicide.
With telePsychiatry, these assessments could be done by a remote tele psychiatrist or tele psych provider, freeing up clinicians and other staff for other patients.
The Benefits of telePsychiatry
TelePsychiatry is an efficient use of scarce mental health resources.
With an increase in the number of patients visiting the emergency room with mental health and substance abuse issues, telePsychiatry can help decrease wait times for all patients. Reimbursement for mental health patients is substantially lower than for other patients. By using telepsych health services, hospitals can free up ED staff to see other, higher reimbursement patients faster.
Frequently Asked Questions
Access TeleCare telePsychiatry can support psychiatric evaluations across the behavioral health care continuum, including emergency department crisis assessments, inpatient behavioral health admissions, consultation-liaison evaluations in Med-Surg and ICU units, and outpatient psychiatric evaluations. Access TeleCare clinicians can assess behavioral health symptoms, substance-use concerns, suicide or self-harm risk, medication needs, psychiatric comorbidities, and disposition questions. The consultation includes chart review, a virtual patient evaluation, collaboration with the onsite care team, and recommendations documented in the hospital EMR. The goal is to help hospitals move patients toward the right treatment plan and next care setting without waiting for scarce local psychiatric coverage.
Access TeleCare telePsychiatry can support medication management for behavioral health patients in emergency, inpatient, Med-Surg, ICU, and outpatient settings. Access TeleCare clinicians review the patient’s psychiatric history, current diagnoses, medication regimen, medical condition, safety concerns, and care setting before making medication recommendations. In inpatient and outpatient programs, this may include ongoing medication management, treatment plan updates, psychotherapy when appropriate, and follow-up support. In acute care settings, medication recommendations are coordinated with the onsite medical team, including ED physicians, hospitalists, intensivists, nurses, pharmacists, case managers, and discharge planners responsible for the patient’s overall care.
Access TeleCare telePsychiatry response times depend on the care setting and coverage model. Emergency departments can request an Access TeleCare behavioral health consultation through a 24/7/365 web portal, with a guaranteed response within two hours. Med-Surg and ICU psychiatric consultations are typically scheduled for same-day or next-day support. Inpatient behavioral health units and behavioral health hospitals can use Access TeleCare for 24/7/365 on-call coverage, daily rounding, and medical directorship. Outpatient programs schedule appointments through their established practice management workflows. Hospitals should avoid applying one response-time claim across every teleBehavioral Health use case.
What types of psychiatric conditions can be managed through Access TeleCare telePsychiatry services?
Access TeleCare telePsychiatry services can support patients with psychiatric and substance-use concerns that require evaluation, treatment planning, medication management, stabilization, or follow-up. Common use cases include depression, anxiety, psychosis, bipolar disorder, agitation, suicidal ideation or self-harm risk, substance-related presentations, medication-related concerns, and psychiatric comorbidities that complicate medical care. Access TeleCare clinicians can also support patients with mental status changes, behavioral symptoms during hospitalization, and complex discharge or placement needs. The local care team determines when a virtual psychiatric consultation is clinically appropriate based on the patient’s condition, hospital policy, and available care setting.
Access TeleCare telePsychiatry supports hospital psychiatric consultation services by giving care teams access to behavioral health clinicians who work within the hospital’s existing workflows. Emergency departments can use Access TeleCare for rapid behavioral health assessment and disposition support. Inpatient behavioral health units and behavioral health hospitals can use the service for admissions, daily rounding, on-call coverage, medication management, discharge documentation, and medical directorship. Med-Surg and ICU teams can request consultation-liaison psychiatric support for medically complex patients with behavioral health comorbidities. Access TeleCare clinicians review the chart, evaluate the patient virtually, collaborate with onsite teams, and document recommendations in the EMR.
Access TeleCare telePsychiatry can support involuntary commitment and psychiatric assessment workflows by providing timely psychiatric evaluation, risk assessment, clinical documentation, and recommendations for the next appropriate care setting. Access TeleCare clinicians can assess behavioral health symptoms, safety concerns, suicide or self-harm risk, medication needs, and disposition considerations, then communicate findings to the onsite team. The legal process for involuntary commitment remains governed by state law, hospital policy, local medical staff, and applicable court or civil processes. Access TeleCare supports the clinical assessment and documentation that help hospital teams make informed decisions within those requirements.
Access TeleCare telePsychiatry recommendations are documented in the hospital or clinic EMR according to the workflow established with the care team. Documentation may include the psychiatric assessment, relevant history, clinical findings, risk considerations, medication recommendations, treatment plan, disposition recommendation, follow-up needs, progress notes, or discharge summary. Access TeleCare clinicians can also communicate directly with ED physicians, hospitalists, nurses, case managers, utilization management teams, and other onsite clinicians. This EMR-based model keeps behavioral health recommendations in the same clinical record used by the local team and supports coordinated decision-making across the patient’s care episode.
Access TeleCare telepsychiatrists are part of a national network of specialty clinicians with deep clinical expertise and telemedicine experience. Access TeleCare’s behavioral health programs include psychiatrists and advanced practice clinicians who support emergency, inpatient, consultation-liaison, behavioral health hospital, and outpatient care models. Clinicians are licensed, credentialed, and privileged according to the requirements of the states, hospitals, and programs they serve. Access TeleCare’s behavioral health service line is also led by board-certified psychiatric leadership, giving partner hospitals clinical oversight, quality focus, and operational support for virtual psychiatric care across the continuum.
Yes. Access TeleCare telePsychiatry can support complex psychiatric case reviews and second opinions when hospitals need additional psychiatric expertise for high-acuity, unclear, or difficult-to-place patients. Access TeleCare clinicians can review the medical record, assess the patient virtually, evaluate medication and safety considerations, and collaborate with the onsite care team on treatment or disposition recommendations. This support can be especially useful in emergency departments, inpatient behavioral health units, behavioral health hospitals, and Med-Surg or ICU settings where psychiatric symptoms intersect with medical complexity. The second-opinion workflow should be defined during implementation and aligned with hospital policy.
